Related Experiment Video
Updated: Jun 14, 2026

Intracoronary Acetylcholine Provocation Testing for Assessment of Coronary Vasomotor Disorders
Published on: August 18, 2016
Negative association between resting blood pressure and chest pain in people undergoing exercise stress testing for
Blaine Ditto1, Kim L Lavoie, Tavis S Campbell
1Department of Psychology, McGill University, Montreal, QC, Canada Montreal Behavioural Medicine Centre, Montreal Heart Institute, A University of Montreal Affiliated Hospital, Montreal, QC, Canada Montreal Behavioural Medicine Centre, Sacré-Cœur Hospital, A University of Montreal Affiliated Hospital, Montreal, QC, Canada Department of Psychology, University of Quebec at Montreal (UQAM), Montreal, QC, Canada Department of Psychology, University of Calgary, Calgary, AB, Canada Department of Exercise Science, Concordia University, Montreal, QC, Canada.
Abstract:
Sustained and acute increases in blood pressure can dampen pain in experimental animals and humans. The most important clinical implication of this relationship may be the phenomenon of silent cardiac ischemia. High blood pressure is common in people at risk for cardiac ischemia and may reduce angina, the key symptom of life-threatening ischemia. The relationship between resting blood pressure and angina was examined in 904 people undergoing exercise stress testing for coronary artery disease. The presence or absence of ischemia was documented with single photon emission computed tomography (SPECT). Participants with ischemia had higher scores on the McGill Pain Questionnaire (MPQ) following exercise though this was moderated significantly by diastolic blood pressure (DBP), especially in women. People with higher pre-exercise resting DBP who displayed SPECT-diagnosed ischemia had MPQ scores comparable to people who did not display ischemia, independent of age, exercise duration, medication, and cardiac history. Awareness of the potential association between blood pressure and angina may provide patients with coronary artery disease and their physicians' important guidance.
Related Concept Videos
Exercise Stress Test
Exercise stress testing, commonly known as a treadmill test, is a noninvasive procedure used to evaluate cardiovascular function and diagnose heart conditions.
Definition
An exercise stress test measures the heart's response to exertion using a treadmill or stationary bicycle. Chest electrodes record the heart's electrical activity through an ECG, and blood pressure is monitored regularly.
Purposes
Angina III: Clinical Manifestations and Assessment
Measurement of Blood Pressure
Angina I: Introduction
Exercise and Cardiovascular Response
Light to moderate physical activity initiates a series of interconnected responses in the body. The heart rate modestly increases in anticipation of the workout, followed by widespread vasodilation as oxygen consumption by skeletal muscles increases. This results in decreased peripheral resistance, increased capillary blood flow, and accelerated...
Special considerations while measuring blood pressure
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
